Title

Author

Date of Award

3-4-2008

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Harry Moscovitz

Abstract

The purpose of this research is to evaluate the short term effectiveness of the use of more active intervention in helping asthmatics who present to the emergency department with an acute exacerbation to quit smoking. Currently, most people who present to the emergency department with an asthma exacerbation are asked about their smoking habits; however, that is usually where the conversation ends. Some patients are advised to quit smoking, but there are very few who are actually formally counseled. There are even fewer who are offered help with smoking cessation, whether it is a referral to a quitline, nicotine replacement, or pharmacological intervention. The first hypothesis for this study is that by using Nicotine Replacement Therapy (NRT) coupled with a Brief Motivational Intervention (BMI) there will be a higher rate of smoking cessation in this population versus the standard care provided in a typical emergency department visit for acute asthma exacerbation. Furthermore, participants in the NRT/BMI group will have a reduction in the number of cigarettes smoked per day. This study is targeting a specific subset of emergency department patients; smokers presenting with an acute asthma exacerbation. A good percentage of these patients are aware that their smoking may impact their asthma symptoms. However, they may not have previously attempted to quit. There is a great deal of research about smoking and asthma. The second hypothesis of this study is that the group that received the NRT/BMI will have greater improvement of their asthma symptoms when compared to the group that received standard care. This was measured using the number of return visits for asthma, peak flow, and medication requirements. The primary aims of the study are as follows: 1. To evaluate the effectiveness of NRT/BMI for increasing rates of smoking cessation in Emergency Department patients presenting with acute exacerbations of asthma as measured by carbon monoxide levels, and self-reported tobacco use. 2. To assess the effectiveness of NRT/BMI in improving asthma outcomes as measured by peak expiratory flow rates, unscheduled medical visits for asthma, and medication requirements. The secondary aim of this study was to evaluate the effectiveness of NRT/BMI in reducing cigarette consumption among asthmatic smokers.